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07/01/2014

Dental licensure fees rising


Dental licensure fees are on the rise as the Dental Board of California struggles with rising costs that have led to a significant budget deficit.

An increase in initial licensure and biennial renewal fees from $365 to $450 took effect July 1, the current maximum allowed under law, which the Dental Board approved last fall. However, the board still projects a deficit even with the increase to $450. Consequently, the board sponsored SB 1416 (Block; D-San Diego) this year, which was signed into law last month and raises the fee to $525 effective Jan. 1, 2015 - the amount the Department of Consumer Affairs has determined the board needs to remain financially solvent.

The board's deficit is primarily due to increased enforcement expenses mandated, but not funded, by the Department of Consumer Affairs, as well as the costs of inflation since the last fee increase in 1998, when the fee increased from $240 to $365 (an increase from $365 to the $525 proposed fee in SB 1416 would be a 2.5 percent annual inflation adjustment). The board has also stated that a lack of continuity in staff has disrupted long-range financial planning.

CDA provided written comments last fall on the board's proposed increase to $450, acknowledging the length of time that these fees had remained the same but emphasizing CDA's expectation that the board's level of customer service and responsiveness must be demonstrably improved as a result of any increase. CDA also urged the board to make smaller, more incremental changes in the future.

As the Legislature considered SB 1416, several legislators made clear their frustration with the lack of foresight and long-range planning from the board that now necessitates two significant fee increases six months apart after no increases since 1998. There is consensus that a thorough analysis of the board's expenses and structure is needed to prevent this situation from occurring again (one of the board's own recommendations is a comprehensive review of its organizational structure and workload).

However, without an increase to $525 through SB 1416 the board maintains it would have to reduce its current level of operations. This will affect key functions such as licensure renewals and enforcement processes, which would jeopardize adequate oversight of the profession and patient safety. With these concerns in mind, the Legislature ultimately approved SB 1416 and Gov. Jerry Brown signed the bill into law.

Even with an increase to $525 through SB 1416, the issue remains as to what the cap should be to allow the board to raise fees incrementally through the regulatory process in the future. The board has said it wants to pursue a cap of $700, based on an analysis of fees necessary to sustain board operations over the next 10 years.

CDA is strongly advocating that the comprehensive analysis of the board's structure and finances must occur prior to any fee or cap increases for the board that go beyond the immediate need. This analysis will take place as a part of the board's "sunset review," scheduled for next year. Sunset review is a process by which the Legislature periodically evaluates every state professional licensing body to determine whether it is carrying out its functions effectively, and ultimately whether it should continue to exist or be modified in some way.

CDA will continue to advocate on behalf of members to ensure fees rise only as high as necessary, that the revenue generated is spent prudently and that customer service is considered an essential and important board function.